CAPITALLAND LACROSSE AND FIELD HOCKEY
CO-PRESIDENTS - GARY R. WEISS
CHAD C. FINCK
7 AZALEA COURT
CLIFTON PARK, NY 12065
Web site – capitallandlacrosse.com
E-mail - [email protected]
PH. 527-1340
PH. 527-6110
MARCH & early APRIL
INDOOR FIELD HOCKEY
FOR GIRLS 2017
For over twenty five years Capitalland Field Hockey Club has been offering the highest quality instructional programs to the youth of the
Capital District. This March and beginning April we will be offering the skills & drills / live scrimmage programs listed below. These
programs will highlight our expert coaching staff’s ability to teach the advanced, novice & beginner players the right way to play field
hockey. Our coaches will use the same skills, drills & live scrimmages that they have used to mold numerous all league and all American
field hockey players in the past. These programs are just what a player needs to develop the skills they need to make and start on their
schools fall teams. Players will be assigned to groups based on their age & skill level. Advanced players can “play up”. OUR REGISTRATION
FORM ON THE NEXT PAGE. We do allow pay per session players in these programs for a fee of $26 per session.
SKILLS AND DRILLS PROGRAMS *Players will be separated by age and skill levels.
GIRLS GRADES 9- 12 ADVANCED LEVEL: This program is for the advanced field hockey player who has been playing field hockey
for a number of years and is looking to improve her skill level while being introduced to more advanced techniques that she will
need to earn a starting position on their schools varsity, or JV team in the fall. Each night we will have a half an hour S & D session
and a half an hour scrimmage. Play time on Monday evenings from 5:30 to 6:30 pm
GIRLS GRADES 6-10 NOVICE LEVEL: This program is for the novice field hockey players who need to sharpen their basic skills while
being introduced to more advanced techniques that will help them gain a position on their JV or modified schools team in fall. Each
night a scrimmage will be held. Play time on Monday evenings from 5:30 to 6:30 pm
GIRLS GRADES 3-9 BEGINNER LEVEL: This program is for girls who are beginners who want to learn how to play field hockey in a
friendly and fun atmosphere. Play time on Monday evenings from 5:30 to 6:30 pm
PROGRAM DETAILS
DATES/LOCATION/DIRECTIONS: All programs will start on Monday 3/6 and end on 4/10. This six week session will be held on the indoor turf
fields at the Sportsplex of Halfmoon which is located at 6 Corporate Drive in Halfmoon. – Get off exit 8A of the Northway. Head East off the exit until
you reach Route 9. Turn left & go about two miles. The Sportsplex is on the left behind the Soccer Unlimited Store. Enter Corporate Drive at the sign for
Pai’s Tae-Kwon-Doe.
REGISTRATION: to register fill out the back section of this form and mail it to 7 Azalea Court Clifton Park NY 12065 with a check made out to
Capitalland Lacrosse. We will also be accepting applications ½ hour prior to each scheduled session at the Sportsplex as long as spots are available.
All players most show up the first night 20 minutes prior to the start of their program to check in.
COSTS OF THE PROGRAMS – The cost for each player to play is $130 when signing up by 3/4/17 & $140 after that date. A $30 non-refundable deposit
is included in our fees. We do allow pay per day players in our instructional programs the fee is $26 per session.
SPORTSPLEX FEE: The Sportsplex also is requiring a one time, yearly access fee of $12 that is payable to them. This is not a fee that we charge so do
not pay us or include it in the check you send us to register your son. Any & all players who play at the Sportsplex are charged this fee. If you have already
paid this fee to the Sportsplex within the past year for any sport you do not have to pay it again for a full year. If you have not, then please go on line before
the first night & do this by going to sportsplexofhalfmoon.com & click the link in the top right corner that reads Member Login. Sportsplex is 383-0991 if
help is needed.
EQUIPMENT – will be available to rent for the season on the first night for a small fee. All girls programs need a stick, shin guards, and goggles.
A security deposit is required that will be given back when the equipment is returned. All players need a mouth piece which we will have available for $5 if
one is needed.
DICK’S SPORTING GOOD STORE IS THE OFFICIAL SPONSOR OF CAPITALLAND FIELD HOCKEY
E-MAIL US AT [email protected] TO BE PUT ON OUR E-MAIL LIST
Visit our website at www.capitallandlacrosse.com for information about all of our winter/spring/summer & fall programs.
E-MAIL US AT [email protected] TO BE PUT ON OUR E-MAIL LIST
REGISTRATION FORM FOR MARCH FIELD HOCKEY
PROGRAMS INFORMATION IS LISTED ON THE OTHER SIDE
Name_____________________________________ E- mail address: ________________________________ Date of birth____________
Mailing Address ______________________________________City___________________ Zip___________ Phone ______________
Emer. Phone __________________
Experience __________
Are you new to the Capitalland? Yes
No
Grade level _____________
Playing position _____________
Are you currently receiving our emails Yes / No ?
CIRCLE THE PROGRAM LISTED BELOW THAT YOU WOULD LIKE TO JOIN
* * All programs will start on Monday 3/6 and end on 4/10
Players will be separated by age and skill levels.
Coaches’ corner advanced skills grades 9 - 12
Play time on Monday evenings from 5:30 to 6:30 pm
Novice level grades 6-10
Play time on Monday evenings from 5:30 to 6:30 pm
Beginner level grades 3-9
Play time on Monday evenings from 5:30 to 6:30 pm
COSTS OF THE PROGRAMS – The cost for each player to play is $130 when signing up by 3/4/17 & $140 after that date. A $30 non-refundable deposit
is included in our fees. We do allow pay per day players in our instructional programs the fee is $26 per session. Please make checks out to
Capitalland Field Hockey. Our mailing address is 7 Azalea Ct. Clifton Park NY 12065.
Bad weather: If weather conditions are threatening, please contact 527-1340 or 527-6110 one hour before play begins to see if lax is still on.
______________________________________________________________________________________________________________
MEDICAL TREATMENT AUTHORIZATION
PLAYERS NAME_______________________________________________ I/We, being the legal parent(s) / guardian (s) of the applicant,
do hereby authorize Capitalland Lacrosse Club, Inc. & it’s duly authorized agent(s) permission to request medical treatment, as necessary, to
assure the well-being of our child. PARENT / GUARDIAN’S SIGNATURE - ______________________________________________
MEDICAL INFORMATION SECTION (To be completed by a parent or guardian)
As stated on our Insurance Waiver forms, there always is a risk that injury (ies) or various physical/emotional conditions may result in a need
for medical attention. To help the coaches & staff better monitor & respond to these possibilities, please describe any restriction(s) that may
apply, & any medication needs that require our attention.
RESTRICTIONS: _________________________________
MEDICAL NEEDS: ___________________________________________
Coverage for accidental injury is required for all participants. Your family health plan is your level of protection. Our insurance contract
allows no one to play in a Capitalland program until proof is provided and both waiver and release forms are completed.
_______________________________________
FAMILY HEALTH INSURANCE COMPANY
______________________________________________
HEALTH INSURANCE POLICY NUMBER
You are engaging in a physically strenuous sporting activity that can result in physical contact and unintended injury. As the parent(s) /
guardian (s) of the applicant in the Capitalland Lacrosse program I agree to, waive, discharge & covenant not to sue the Capitalland Lacrosse
Club, Inc., their affiliated clubs, their respective administrators, participants, sponsoring agencies, sponsors, advertisers, and if applicable,
owners and leasers of premises used to conduct the events, all of which are hereinafter referred to as “releases:, from any and all LIABILITY
to each of the undersigned, his or her heirs and next of kin for any & all claims, demands, losses or damages on account of injury, including
death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise. I HAVE
READ THE ABOVE WAIVER & RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT
AND SIGN IT VOLUNTARILY.
(Signature parent / guardian) _______________________________ (Printed Name of parent / guardian) _______________________